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Bill would limit costs to N.D. county jails for inmate health care

County jails across North Dakota could benefit this Legislative session with the passage of two proposed bills that would help cover medical expenses for inmates currently paid by the jails.

Senate Bill 2024 would make inmates financially responsible for the costs of medical or health care and correctional facilities could seek reimbursement for the total amount of incurred medical costs.

If an inmate does not have health insurance, the responsibility of the costs for care would fall on the facility but the responsibility would not exceed the rates paid under the federal Medicare program.

The Stutsman County Correctional Center, as every other county jail in the state, currently pays for preexisting conditions as well as any that may occur while incarcerated.

"It's everything from a cold or flu to a bad back to more serious things -- medication, dental and those things can be big areas," said Tracey Trapp, administrator at SCCC.

Trapp said one major event, like a heart attack, could wipe the $40,000 medical budget out for the year.

"With local budgets the way they are nobody would want to go to the commission and explain a catastrophe expense the county would have to pay for," Trapp said.

That's where Senate Bill 2028 is supposed to come in. That bill would have the North Dakota Department of Corrections cover any medical costs over $10,000.

As of Thursday, the SCCC housed 75 inmates and 20 of them were local, Trapp said. The other 55 either came from 11 nearby counties, the state or the federal government.

The medical costs for those 55 are paid by the agency that contracted them to serve at SCCC.

In 2009 medical bills for the SCCC totaled more than $107,000, which is the fourth highest of all 26 county jails in the state. Proportionately SCCC can hold the sixth most inmates with a rated capacity of 84.

The reason the medical costs don't line up with the population is because costs for those contracted inmates were added to the total medical costs paid for local inmates, Trapp said. There is also a full-time nurse whose pay is represented in that $107,000.

"This whole thing with medical costs has been an ongoing concern for a number of years," he said "It's a very difficult thing for local government to wrap their heads around."

Mark Klose, Stutsman County Commission chairman, said he has been meeting with Trapp for the past few years on medical costs for inmates housed at SCCC.

"We've talked about how we need to do something to cover our hind ends," Klose said.

He said the funds to pay for a catastrophic medical event would have to come from the county's emergency fund if the medical budget was depleted.

"If something happens, we have to pay. We couldn't get away from that expense," said Noel Johnson, Stutsman County chief operating officer.

That expense could easily be huge and place a heavy burden on a balanced budget.

"Literally you could get hit with a quarter-million-dollar or half-million-dollar medical bill," Johnson said.

All three officials expressed interest in both bills but said taking money from the Department of Corrections for SB 2028 may prove difficult because it would be coming from and established budget.

The possibility of forming an insurance pool with other counties may prove to be a prudent option as well.

But the possibility of a reduction in costs is still good fiscal news for the county.

"We need to do something and that's what these two bills are trying to do," Klose said.